{"formatVersion":"1.1","id":"https://www.mentalhealth.com/library/ptsd-and-addiction","path":"/library/ptsd-and-addiction","url":"https://www.mentalhealth.com/library/ptsd-and-addiction","title":"Post-traumatic stress disorder (PTSD) and Addiction","family":"Library detail","description":"Discover the link between PTSD and addiction, including symptoms and how it fuels substance abuse. Treating both disorders is vital for successful recovery.","language":"en-US","access":{"audience":"public","indexable":true},"provenance":{"sourceUrl":"https://www.mentalhealth.com/library/ptsd-and-addiction","wordpressId":"5469","contentCompleteness":"complete","dateScope":"original-source"},"authors":[],"dates":{"datePublished":"2024-05-31T23:31:48Z","dateModified":"2026-05-17T19:27:51Z"},"content":{"html":"

Post-traumatic stress disorder (PTSD) and Addiction

Published on · Updated on
\n
\n

Case Example

\nJanet has checked into treatment for the third time. It’s been three weeks, and her detox from alcohol is complete. However, her counselor notices that Janet still appears emotionally flat, seems to be hypervigilant and easily startled, and appears exhausted as a result of vivid dreams that wake her up at night. When she’s startled awake her heart is pounding, and she’s sweating.\n

Janet prefers to spend her free time reading and avoiding the loud teasing and story-telling that the rest of the clients use to bond. If she’s honest, the noise makes her want to bite their heads off, which makes her feel bad about herself. It’s the same reason she avoids her family when she’s home and drinks to “calm down.”

\n

Like many clients in treatment, particularly clients with a multiple relapse history, Janet will continue to struggle with her alcohol use unless the treatment team recognizes that she needs to address the symptoms of Post Traumatic Stress that derail her sobriety.

\n
\n
\n
\n

Post-traumatic stress disorder (PTSD) and Addiction

\nAround 50% of individuals seeking substance use treatment also meet criteria for Post-traumatic Stress Disorder (PTSD), and individuals with a co-occurring PTSD/Substance Use Disorder (SUD) tend to have poorer treatment outcomes than those without such comorbidity[1].\n
\n
\n
Evolution and Definition of PTSD
\n
\n

\nPTSD was initially described as “shell shock” for returning veterans. Our understanding of this painful disorder has evolved in the DSM-5 to identify a broader range of trauma-inducing stressors, including exposure or threat of death, actual or threatened serious injury, or actual or threatened sexual violence. It’s important to identify that the stressor can be experienced directly or by witnessing, indirectly.\nDSM-5 Symptoms for PTSD\n

\n
\nSymptom patterns are clustered into criterion:[2]\n
    \n
  • Criterion A refers to the exposure to actual or threatened death, serious injury, or sexual violence. These can either be directly or indirectly (e.g., learning of a traumatic event of a family member) experienced.
    • \n
  • Criterion B includes intrusion symptoms. These may be recurrent or intrusive memories or dreams, and may include flashbacks.
    • \n
  • Criterion C includes avoidance symptoms. This is demonstrated by persistent effortful avoidance of distressing trauma-related stimuli after the event (e.g., people, places, conversations, situations) Alcoholism and drug abuse fall into the category of avoidance symptoms, as the individual may use these chemicals to avoid memories or to numb fear.
    • \n
  • Criterion D includes negative alterations in cognitions and mood. These changes in mood occur or worsen after the trauma and may include persistent and distorted negative beliefs, self- blame, lack of interest in former interests, feeling separate from others, and feeling emotionally flat.
    • \n
  • Criterion E includes alterations in arousal and reactivity that began or worsened after the trauma. These include irritability, recklessness, hypervigilance, exaggerated startle response, poor concentration, and poor sleep.
    • \n
  • Criterion F refers to these symptoms lasting more than 1 month.
    • \n
  • Criterion G notes that these symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
    • \n
  • Criterion H highlights that these disturbances are not due to the effects of a substance or another medical condition. In other words, the PTSD symptoms arise independently from any physiological effects of using drugs, alcohol, or medication.
    • \n
\n
\n
\"An

Key takeaways

  • PTSD and substance use problems can reinforce one another when alcohol or drugs are used to manage trauma-related distress.
  • Temporary relief may obscure persistent symptoms and interfere with recovery.
  • Integrated care addresses both conditions, including trauma triggers, coping skills, and coordinated relapse prevention.

Video: Post-traumatic stress disorder (PTSD) and Addiction

\nA great discussion is provided on PTSD and addiction causes, symptoms, and treatments. \"Posttraumatic Growth\" is discussed, a process whereby those with PTSD experience remarkable growth due to the challenges they have faced.

How Does Post-traumatic stress disorder (PTSD) Develop?

Most people who experience trauma do not develop PTSD. The U.S. Department of Veterans Affairs estimates that about 6% of U.S. adults will experience PTSD at some point in their lives. Risk varies with the nature of the trauma and other factors, including direct exposure or injury[3].

When we encounter stress, our sympathetic (“fight, flight, or freeze”) system responds, our adrenal system is triggered, cortisol is released, and our body becomes
prepared to move toward the threat (fight), move away from the threat (flight), or we may even dissociate (freeze). Afterward, our parasympathetic (“rest, digest, and heal”) system takes over, and our bodies are restored to “normal” functioning.

\nIn PTSD, we do not fully return to the parasympathetic system and are therefore always primed for a fight-flight-freeze reaction. We are never fully at rest, always vigilant and may have distorted perceptions of threat. An analogy might be to keep your foot on the gas pedal without letting up.

Sooner or later the engine will begin to burn out. It is not uncommon for PTSD suffers to develop accompanying stress-based disorders such as fibromyalgia, chronic fatigue, clinical depression, or colitis. A sizeable portion also go on to develop an addiction.\n

Subject matter expert

\"\"

Brian Thompson Ph.D.

Trauma and post-traumatic stress disorder

The Role of Addiction in Post-traumatic stress disorder (PTSD)

    \n
  • \n
    Chemical dependency is often described as an attempt at self-regulation, not so terribly different from self-injury other types of trauma-related impulsive behavior. From this perspective, we come to see that addiction is a result of an attempt to ward off the intrusive memories, smooth out hypervigilance, and disconnect from anxiety.
    • \n
  • \n
    When alcohol or drugs are used to manage PTSD symptoms, the symptoms of the disorder only become more severe. As a central nervous system depressant, alcohol and opiates can worsen depression and anxiety and interfere with normal sleep patterns.
    • \n
  • \n
    We might mistakenly believe that treating the trauma will stop the alcohol and drug abuse. However, addiction may continue to persist given that the substance has hijacked our reward system, causing us to develop enduring tolerance (need more of the substance to get the same effect) and withdrawal (physical consequences and discomfort when substance use stops) symptoms.
    • \n

 \n

For these reasons, addiction issues must always be addressed concurrently in trauma recovery, because the substance abuse will consistently undermine all other treatments by impairing our memory, perception, and judgment.

Similarly, trauma issues should always be addressed concurrently in addiction recovery, given that the presence of trauma symptoms makes substance abuse much more likely.

\nSuccessful recovery requires clients to understand how the addictive substances have helped them survive: that is, which trauma symptoms have they been attempting to treat through drinking and drugging?

We need to know this because the trauma symptoms will increase when we enter sobriety, and we will need coping strategies to manage the triggers of PTSD when they appear. Relapse prevention plans must create strategies to manage both addiction and PTSD symptoms and triggers.\n

Trauma-Informed Treatment

\nSuccessful trauma-informed treatment might include combinations of:\n

    \n
  • Psychoactive medication, if necessary, to address hyperarousal.
    • \n
  • Mindfulness and distress tolerance skills to address arousal and disconnection from the self.
    • \n
  • Cognitive Behavioral Therapies to address the distortions in thinking that occur as a symptom of both addiction and PTSD.
    • \n
  • Both inpatient and outpatient treatment centers may offer these options. Be sure to ask the treatment provider if they treat co-occurring trauma and addiction.
    • \n

\nSubstance Abuse and Mental Health Services Administration (SAMHSA) has a great online resource for finding treatment near you: SAMHSA\nCase Example: Revisited\n

\n
\n

Janet’s counselor had recently completed a co-occurring disorder course and recognized the significance of Janet’s history of domestic violence leading to her husband's 5-year prison term. Janet had not considered the impact of the violence on her use of alcohol because he’s incarcerated. However, her symptoms continued to persist and were influencing her drinking habits.

\n

It was not in the scope of practice for Janet's CADC counselor to treat her PTSD, but she asked Janet about her symptoms and was able to make a referral to a local mental health counselor and psychiatrist who often treat substance abusers with mental health issues.

\n

Also, her counselor placed Janet in the program's “Seeking Safety” group, gave her an information sheet about PTSD so that Janet could see that she wasn’t just “crazy,” and encouraged Janet to keep a journal of her PTSD symptoms triggers along with her alcohol triggers.

\n

When it comes time to write Janet's relapse prevention plan she will write the plan for both PTSD and addiction management. Addressing both of these disorders together will increase Janet’s likelihood of finding sobriety and greater health.

\n


References

  1. Brady, K. T., Back, S. E., & Coffey, S. F. (2004). Substance abuse and posttraumatic stress disorder. Current Directions in Psychological Science,13(5), 206-209. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 5th Edition (DSM-5). Arlington, VA: American Psychiatric Association.
  2. Joseph Volpicelli, M.D., Ph.D.; Geetha Balaraman; Julie Hahn; Heather Wallace, M.A.; and Donald Bux, Ph.D. The Role of Uncontrollable Trauma in the Development of PTSD and Alcohol Addiction. (1999). Alcohol Research & Health, Vol. 23, No. 4, pgs 256-262.
  3. National Center for PTSD. (2026, September 25). How common is PTSD in adults? U.S. Department of Veterans Affairs. ptsd.va.gov. Accessed October 10 2026.

About MentalHealth.com

MentalHealth.com helps people understand themselves, build healthier relationships, and access the right care. We bring together mental health education, diagnostics, and care management to support well-being throughout every phase of life.

\"\"

Related community

Post-Traumatic Stress Disorder

A space for perspectives on PTSD, personal experiences, and connection after trauma.

","text":"Home Library Post-Traumatic Stress Disorder PTSD and Addiction Post-traumatic stress disorder (PTSD) and Addiction Published on May 31, 2024 · Updated on May 17, 2026 Case Example Janet has checked into treatment for the third time. It’s been three weeks, and her detox from alcohol is complete. However, her counselor notices that Janet still appears emotionally flat, seems to be hypervigilant and easily startled, and appears exhausted as a result of vivid dreams that wake her up at night. When she’s startled awake her heart is pounding, and she’s sweating. Janet prefers to spend her free time reading and avoiding the loud teasing and story-telling that the rest of the clients use to bond. If she’s honest, the noise makes her want to bite their heads off, which makes her feel bad about herself. It’s the same reason she avoids her family when she’s home and drinks to “calm down.” Like many clients in treatment, particularly clients with a multiple relapse history, Janet will continue to struggle with her alcohol use unless the treatment team recognizes that she needs to address the symptoms of Post Traumatic Stress that derail her sobriety. Post-traumatic stress disorder (PTSD) and Addiction Around 50% of individuals seeking substance use treatment also meet criteria for Post-traumatic Stress Disorder (PTSD), and individuals with a co-occurring PTSD/Substance Use Disorder (SUD) tend to have poorer treatment outcomes than those without such comorbidity[1]. Evolution and Definition of PTSD PTSD was initially described as “shell shock” for returning veterans. Our understanding of this painful disorder has evolved in the DSM-5 to identify a broader range of trauma-inducing stressors, including exposure or threat of death, actual or threatened serious injury, or actual or threatened sexual violence. It’s important to identify that the stressor can be experienced directly or by witnessing, indirectly. DSM-5 Symptoms for PTSD Symptom patterns are clustered into criterion:[2] Criterion A refers to the exposure to actual or threatened death, serious injury, or sexual violence. These can either be directly or indirectly (e.g., learning of a traumatic event of a family member) experienced. Criterion B includes intrusion symptoms. These may be recurrent or intrusive memories or dreams, and may include flashbacks. Criterion C includes avoidance symptoms. This is demonstrated by persistent effortful avoidance of distressing trauma-related stimuli after the event (e.g., people, places, conversations, situations) Alcoholism and drug abuse fall into the category of avoidance symptoms, as the individual may use these chemicals to avoid memories or to numb fear. Criterion D includes negative alterations in cognitions and mood. These changes in mood occur or worsen after the trauma and may include persistent and distorted negative beliefs, self- blame, lack of interest in former interests, feeling separate from others, and feeling emotionally flat. Criterion E includes alterations in arousal and reactivity that began or worsened after the trauma. These include irritability, recklessness, hypervigilance, exaggerated startle response, poor concentration, and poor sleep. Criterion F refers to these symptoms lasting more than 1 month. Criterion G notes that these symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion H highlights that these disturbances are not due to the effects of a substance or another medical condition. In other words, the PTSD symptoms arise independently from any physiological effects of using drugs, alcohol, or medication. Key takeaways PTSD and substance use problems can reinforce one another when alcohol or drugs are used to manage trauma-related distress. Temporary relief may obscure persistent symptoms and interfere with recovery. Integrated care addresses both conditions, including trauma triggers, coping skills, and coordinated relapse prevention. Video: Post-traumatic stress disorder (PTSD) and Addiction A great discussion is provided on PTSD and addiction causes, symptoms, and treatments. \"Posttraumatic Growth\" is discussed, a process whereby those with PTSD experience remarkable growth due to the challenges they have faced. How Does Post-traumatic stress disorder (PTSD) Develop? Most people who experience trauma do not develop PTSD. The U.S. Department of Veterans Affairs estimates that about 6% of U.S. adults will experience PTSD at some point in their lives. Risk varies with the nature of the trauma and other factors, including direct exposure or injury[3]. When we encounter stress, our sympathetic (“fight, flight, or freeze”) system responds, our adrenal system is triggered, cortisol is released, and our body becomes prepared to move toward the threat (fight), move away from the threat (flight), or we may even dissociate (freeze). Afterward, our parasympathetic (“rest, digest, and heal”) system takes over, and our bodies are restored to “normal” functioning. In PTSD, we do not fully return to the parasympathetic system and are therefore always primed for a fight-flight-freeze reaction. We are never fully at rest, always vigilant and may have distorted perceptions of threat. An analogy might be to keep your foot on the gas pedal without letting up. Sooner or later the engine will begin to burn out. It is not uncommon for PTSD suffers to develop accompanying stress-based disorders such as fibromyalgia, chronic fatigue, clinical depression, or colitis. A sizeable portion also go on to develop an addiction. Subject matter expert Brian Thompson Ph.D. Trauma and post-traumatic stress disorder The Role of Addiction in Post-traumatic stress disorder (PTSD) Chemical dependency is often described as an attempt at self-regulation, not so terribly different from self-injury other types of trauma-related impulsive behavior. From this perspective, we come to see that addiction is a result of an attempt to ward off the intrusive memories, smooth out hypervigilance, and disconnect from anxiety. When alcohol or drugs are used to manage PTSD symptoms, the symptoms of the disorder only become more severe. As a central nervous system depressant, alcohol and opiates can worsen depression and anxiety and interfere with normal sleep patterns. We might mistakenly believe that treating the trauma will stop the alcohol and drug abuse. However, addiction may continue to persist given that the substance has hijacked our reward system, causing us to develop enduring tolerance (need more of the substance to get the same effect) and withdrawal (physical consequences and discomfort when substance use stops) symptoms. For these reasons, addiction issues must always be addressed concurrently in trauma recovery, because the substance abuse will consistently undermine all other treatments by impairing our memory, perception, and judgment. Similarly, trauma issues should always be addressed concurrently in addiction recovery, given that the presence of trauma symptoms makes substance abuse much more likely. Successful recovery requires clients to understand how the addictive substances have helped them survive: that is, which trauma symptoms have they been attempting to treat through drinking and drugging? We need to know this because the trauma symptoms will increase when we enter sobriety, and we will need coping strategies to manage the triggers of PTSD when they appear. Relapse prevention plans must create strategies to manage both addiction and PTSD symptoms and triggers. Trauma-Informed Treatment Successful trauma-informed treatment might include combinations of: Psychoactive medication, if necessary, to address hyperarousal. Mindfulness and distress tolerance skills to address arousal and disconnection from the self. Cognitive Behavioral Therapies to address the distortions in thinking that occur as a symptom of both addiction and PTSD. Both inpatient and outpatient treatment centers may offer these options. Be sure to ask the treatment provider if they treat co-occurring trauma and addiction. Substance Abuse and Mental Health Services Administration (SAMHSA) has a great online resource for finding treatment near you: SAMHSA Case Example: Revisited Janet’s counselor had recently completed a co-occurring disorder course and recognized the significance of Janet’s history of domestic violence leading to her husband's 5-year prison term. Janet had not considered the impact of the violence on her use of alcohol because he’s incarcerated. However, her symptoms continued to persist and were influencing her drinking habits. It was not in the scope of practice for Janet's CADC counselor to treat her PTSD, but she asked Janet about her symptoms and was able to make a referral to a local mental health counselor and psychiatrist who often treat substance abusers with mental health issues. Also, her counselor placed Janet in the program's “Seeking Safety” group, gave her an information sheet about PTSD so that Janet could see that she wasn’t just “crazy,” and encouraged Janet to keep a journal of her PTSD symptoms triggers along with her alcohol triggers. When it comes time to write Janet's relapse prevention plan she will write the plan for both PTSD and addiction management. Addressing both of these disorders together will increase Janet’s likelihood of finding sobriety and greater health. Find support that fits you Explore people and care options near you. Find care References Brady, K. T., Back, S. E., & Coffey, S. F. (2004). Substance abuse and posttraumatic stress disorder. Current Directions in Psychological Science,13(5), 206-209. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 5th Edition (DSM-5). Arlington, VA: American Psychiatric Association. Joseph Volpicelli, M.D., Ph.D.; Geetha Balaraman; Julie Hahn; Heather Wallace, M.A.; and Donald Bux, Ph.D. The Role of Uncontrollable Trauma in the Development of PTSD and Alcohol Addiction. (1999). Alcohol Research & Health, Vol. 23, No. 4, pgs 256-262. National Center for PTSD. (2026, September 25). How common is PTSD in adults? U.S. Department of Veterans Affairs. ptsd.va.gov. Accessed October 10 2026. About MentalHealth.com MentalHealth.com helps people understand themselves, build healthier relationships, and access the right care. We bring together mental health education, diagnostics, and care management to support well-being throughout every phase of life. Related community Post-Traumatic Stress Disorder A space for perspectives on PTSD, personal experiences, and connection after trauma. Table of contentsChoose a section Case Example PTSD and Addiction Video: PTSD and Addiction How Does PTSD Develop? The Role of Addiction in PTSD Trauma-Informed Treatment View more","wordCount":1614},"schema":{"@context":"https://schema.org","@graph":[{"@type":"Organization","@id":"https://www.mentalhealth.com/#organization","name":"MentalHealth.com","url":"https://www.mentalhealth.com/","publishingPrinciples":"https://www.mentalhealth.com/publishing/editorial-policy"},{"@type":"WebSite","@id":"https://www.mentalhealth.com/#website","url":"https://www.mentalhealth.com/","name":"MentalHealth.com","inLanguage":"en-US","publisher":{"@id":"https://www.mentalhealth.com/#organization"}},{"@type":"BreadcrumbList","@id":"https://www.mentalhealth.com/library/ptsd-and-addiction#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.mentalhealth.com/"},{"@type":"ListItem","position":2,"name":"Library","item":"https://www.mentalhealth.com/library"},{"@type":"ListItem","position":3,"name":"Post-Traumatic Stress Disorder","item":"https://www.mentalhealth.com/library/ptsd"},{"@type":"ListItem","position":4,"name":"PTSD and Addiction","item":"https://www.mentalhealth.com/library/ptsd-and-addiction"}]},{"@type":"ImageObject","@id":"https://www.mentalhealth.com/library/ptsd-and-addiction#primaryimage","url":"https://www.mentalhealth.com/assets/optimized/a9e83a83cd2bcc8f71326869.webp","contentUrl":"https://www.mentalhealth.com/assets/optimized/a9e83a83cd2bcc8f71326869.webp","width":1200,"height":600,"encodingFormat":"image/webp","caption":"An older man rests his arm around a younger man outdoors."},{"@type":"Article","@id":"https://www.mentalhealth.com/library/ptsd-and-addiction#article","url":"https://www.mentalhealth.com/library/ptsd-and-addiction","headline":"Post-traumatic stress disorder (PTSD) and Addiction","description":"Discover the link between PTSD and addiction, including symptoms and how it fuels substance abuse. Treating both disorders is vital for successful recovery.","wordCount":1381,"mainEntityOfPage":{"@id":"https://www.mentalhealth.com/library/ptsd-and-addiction#webpage"},"publisher":{"@id":"https://www.mentalhealth.com/#organization"},"articleSection":"Post-Traumatic Stress Disorder","citation":[{"@type":"CreativeWork","name":"Brady, K. T., Back, S. E., & Coffey, S. F. (2004). Substance abuse and posttraumatic stress disorder. Current Directions in Psychological Science,13(5), 206-209. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 5th Edition (DSM-5). Arlington, VA: American Psychiatric Association."},{"@type":"CreativeWork","name":"Joseph Volpicelli, M.D., Ph.D.; Geetha Balaraman; Julie Hahn; Heather Wallace, M.A.; and Donald Bux, Ph.D. The Role of Uncontrollable Trauma in the Development of PTSD and Alcohol Addiction. (1999). Alcohol Research & Health, Vol. 23, No. 4, pgs 256-262."},{"@type":"CreativeWork","name":"National Center for PTSD. (2026, September 25). How common is PTSD in adults? U.S. Department of Veterans Affairs. ptsd.va.gov. Accessed October 10 2026.","url":"https://www.ptsd.va.gov/understand/common/common_adults.asp?utm_medium=referral&utm_campaign=libra&utm_content=external_resource&utm_id=site-library-ptsd-and-addiction&utm_source=mentalhealth.com"}],"inLanguage":"en-US","image":{"@id":"https://www.mentalhealth.com/library/ptsd-and-addiction#primaryimage"},"about":{"@type":"Thing","@id":"https://www.mentalhealth.com/library/ptsd#topic","name":"Post-Traumatic Stress Disorder"},"datePublished":"2024-05-31T23:31:48Z","dateModified":"2026-05-17T19:27:51Z"},{"@type":"MedicalWebPage","@id":"https://www.mentalhealth.com/library/ptsd-and-addiction#webpage","url":"https://www.mentalhealth.com/library/ptsd-and-addiction","name":"Post-traumatic stress disorder (PTSD) and Addiction","description":"Discover the link between PTSD and addiction, including symptoms and how it fuels substance abuse. Treating both disorders is vital for successful recovery.","inLanguage":"en-US","isPartOf":{"@id":"https://www.mentalhealth.com/library/ptsd#webpage"},"breadcrumb":{"@id":"https://www.mentalhealth.com/library/ptsd-and-addiction#breadcrumb"},"mainEntity":{"@id":"https://www.mentalhealth.com/library/ptsd-and-addiction#article"},"relatedLink":["https://www.mentalhealth.com/library/how-common-is-ptsd","https://www.mentalhealth.com/library/ptsd-with-psychosis","https://www.mentalhealth.com/library/duration-of-ptsd","https://www.mentalhealth.com/library/trauma-complex-ptsd","https://www.mentalhealth.com/library/treating-ptsd-with-beta-blockers","https://www.mentalhealth.com/people/brian-thompson"],"publisher":{"@id":"https://www.mentalhealth.com/#organization"},"medicalAudience":{"@type":"MedicalAudience","audienceType":"General public"},"primaryImageOfPage":{"@id":"https://www.mentalhealth.com/library/ptsd-and-addiction#primaryimage"},"image":{"@id":"https://www.mentalhealth.com/library/ptsd-and-addiction#primaryimage"},"about":{"@type":"Thing","@id":"https://www.mentalhealth.com/library/ptsd#topic","name":"Post-Traumatic Stress Disorder"},"citation":[{"@type":"CreativeWork","name":"Brady, K. T., Back, S. E., & Coffey, S. F. (2004). Substance abuse and posttraumatic stress disorder. Current Directions in Psychological Science,13(5), 206-209. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 5th Edition (DSM-5). Arlington, VA: American Psychiatric Association."},{"@type":"CreativeWork","name":"Joseph Volpicelli, M.D., Ph.D.; Geetha Balaraman; Julie Hahn; Heather Wallace, M.A.; and Donald Bux, Ph.D. The Role of Uncontrollable Trauma in the Development of PTSD and Alcohol Addiction. (1999). Alcohol Research & Health, Vol. 23, No. 4, pgs 256-262."},{"@type":"CreativeWork","name":"National Center for PTSD. (2026, September 25). How common is PTSD in adults? U.S. Department of Veterans Affairs. ptsd.va.gov. Accessed October 10 2026.","url":"https://www.ptsd.va.gov/understand/common/common_adults.asp?utm_medium=referral&utm_campaign=libra&utm_content=external_resource&utm_id=site-library-ptsd-and-addiction&utm_source=mentalhealth.com"}],"datePublished":"2024-05-31T23:31:48Z","dateModified":"2026-05-17T19:27:51Z"}]},"representations":{"html":"https://www.mentalhealth.com/library/ptsd-and-addiction","json":"https://www.mentalhealth.com/data/library/ptsd-and-addiction.json","jsonLd":"https://www.mentalhealth.com/data/library/ptsd-and-addiction.ld.json"},"$schema":"https://www.mentalhealth.com/data/page.schema.json","images":[{"url":"https://www.mentalhealth.com/assets/optimized/a9e83a83cd2bcc8f71326869.webp","alt":"An older man rests his arm around a younger man outdoors.","width":1200,"height":600},{"url":"https://www.mentalhealth.com/assets/optimized/f3b9d905f1cd6379a2692607.jpg","alt":"","width":64,"height":64},{"url":"https://www.mentalhealth.com/assets/optimized/e959f55a25942c5ead040fba.webp","alt":"","width":1200,"height":800}],"sections":[{"id":"case-example","title":"Case Example","level":2,"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#case-example"},{"id":"ptsd-and-addiction","title":"Post-traumatic stress disorder (PTSD) and Addiction","level":2,"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#ptsd-and-addiction"},{"id":"key-takeaways","title":"Key takeaways","level":2,"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#key-takeaways"},{"id":"video-ptsd-and-addiction","title":"Video: Post-traumatic stress disorder (PTSD) and Addiction","level":2,"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#video-ptsd-and-addiction"},{"id":"how-does-ptsd-develop","title":"How Does Post-traumatic stress disorder (PTSD) Develop?","level":2,"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#how-does-ptsd-develop"},{"id":"the-role-of-addiction-in-ptsd","title":"The Role of Addiction in Post-traumatic stress disorder (PTSD)","level":2,"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#the-role-of-addiction-in-ptsd"},{"id":"trauma-informed-treatment","title":"Trauma-Informed Treatment","level":2,"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#trauma-informed-treatment"}],"references":[{"number":1,"id":"https://www.mentalhealth.com/library/ptsd-and-addiction#substance-abuse-posttraumatic-stress-disorder","text":"Brady, K. T., Back, S. E., & Coffey, S. F. (2004). Substance abuse and posttraumatic stress disorder. Current Directions in Psychological Science,13(5), 206-209. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 5th Edition (DSM-5). Arlington, VA: American Psychiatric Association.","links":[]},{"number":2,"id":"https://www.mentalhealth.com/library/ptsd-and-addiction#alcohol-research-health-vol","text":"Joseph Volpicelli, M.D., Ph.D.; Geetha Balaraman; Julie Hahn; Heather Wallace, M.A.; and Donald Bux, Ph.D. The Role of Uncontrollable Trauma in the Development of PTSD and Alcohol Addiction. (1999). Alcohol Research & Health, Vol. 23, No. 4, pgs 256-262.","links":[]},{"number":3,"id":"https://www.mentalhealth.com/library/ptsd-and-addiction#substance-abuse-mental-health-services-administration-samhsa","text":"National Center for PTSD. (2026, September 25). How common is PTSD in adults? U.S. Department of Veterans Affairs. ptsd.va.gov. Accessed October 10 2026.","links":[{"url":"https://www.ptsd.va.gov/understand/common/common_adults.asp?utm_medium=referral&utm_campaign=libra&utm_content=external_resource&utm_id=site-library-ptsd-and-addiction&utm_source=mentalhealth.com","label":"ptsd.va.gov"}],"url":"https://www.ptsd.va.gov/understand/common/common_adults.asp?utm_medium=referral&utm_campaign=libra&utm_content=external_resource&utm_id=site-library-ptsd-and-addiction&utm_source=mentalhealth.com"}],"relatedReading":[],"links":[{"url":"https://www.mentalhealth.com/","label":"Home"},{"url":"https://www.mentalhealth.com/library","label":"Library"},{"url":"https://www.mentalhealth.com/library/ptsd","label":"Post-Traumatic Stress Disorder"},{"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#substance-abuse-posttraumatic-stress-disorder","label":"[1]"},{"url":"https://www.mentalhealth.com/library/ptsd","label":"PTSD"},{"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#alcohol-research-health-vol","label":"[2]"},{"url":"https://www.mentalhealth.com/library/addiction","label":"addiction"},{"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#substance-abuse-mental-health-services-administration-samhsa","label":"[3]"},{"url":"https://www.mentalhealth.com/library/depression","label":"depression"},{"url":"https://www.mentalhealth.com/people/brian-thompson","label":""},{"url":"https://www.mentalhealth.com/people/brian-thompson","label":"Brian Thompson Ph.D."},{"url":"https://www.mentalhealth.com/library/anxiety","label":"anxiety"},{"url":"https://www.mentalhealth.com/library/relapse-prevention-therapy","label":"Relapse prevention"},{"url":"https://www.mentalhealth.com/library/cognitive-behavioral-therapy","label":"Cognitive Behavioral Therapies"},{"url":"https://www.mentalhealth.com/library/co-occurring-disorders","label":"co-occurring trauma and addiction"},{"url":"https://findtreatment.gov/?utm_medium=referral&utm_campaign=libra&utm_content=external_resource&utm_id=site-library-ptsd-and-addiction&utm_source=mentalhealth.com","label":"SAMHSA"},{"url":"https://www.mentalhealth.com/library/abuse","label":"domestic violence"},{"url":"https://www.mentalhealth.com/therapists?specialty=PTSD","label":"Find care"},{"url":"https://www.ptsd.va.gov/understand/common/common_adults.asp?utm_medium=referral&utm_campaign=libra&utm_content=external_resource&utm_id=site-library-ptsd-and-addiction&utm_source=mentalhealth.com","label":"ptsd.va.gov"},{"url":"https://www.mentalhealth.com/community/post-traumatic-stress-disorder","label":""},{"url":"https://www.mentalhealth.com/community/post-traumatic-stress-disorder","label":"Post-Traumatic Stress Disorder"},{"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#case-example","label":"Case Example"},{"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#ptsd-and-addiction","label":"PTSD and Addiction"},{"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#video-ptsd-and-addiction","label":"Video: PTSD and Addiction"},{"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#how-does-ptsd-develop","label":"How Does PTSD Develop?"},{"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#the-role-of-addiction-in-ptsd","label":"The Role of Addiction in PTSD"},{"url":"https://www.mentalhealth.com/library/ptsd-and-addiction#trauma-informed-treatment","label":"Trauma-Informed Treatment"}],"seo":{"title":"PTSD and Addiction: Connections and Trauma-Informed Treatment","description":"Discover the link between PTSD and addiction, including symptoms and how it fuels substance abuse. Treating both disorders is vital for successful recovery.","canonical":"https://www.mentalhealth.com/library/ptsd-and-addiction","robots":"index,follow","socialImage":{"url":"https://www.mentalhealth.com/assets/optimized/ec9b0cb47c0207d45e88634d.png","width":1200,"height":630,"alt":"MentalHealth.com — Library","type":"image/png","sitemapGroup":"library"}},"breadcrumbs":[{"name":"Home","url":"https://www.mentalhealth.com/"},{"name":"Library","url":"https://www.mentalhealth.com/library"},{"name":"Post-Traumatic Stress Disorder","url":"https://www.mentalhealth.com/library/ptsd"},{"name":"PTSD and Addiction","url":"https://www.mentalhealth.com/library/ptsd-and-addiction"}],"subjectMatterExpert":{"name":"Brian Thompson, Ph.D.","url":"/people/brian-thompson","profileId":"6379","topic":"addiction","focus":"Trauma and post-traumatic stress disorder","selectionBasis":"Documented expertise in the existing published profile","reviewAttribution":false},"keyTakeaways":["PTSD and substance use problems can reinforce one another when alcohol or drugs are used to manage trauma-related distress.","Temporary relief may obscure persistent symptoms and interfere with recovery.","Integrated care addresses both conditions, including trauma triggers, coping skills, and coordinated relapse prevention."],"navigation":[{"label":"Case Example","href":"#case-example","heading":"Case Example"},{"label":"PTSD and Addiction","href":"#ptsd-and-addiction","heading":"Post-traumatic stress disorder (PTSD) and Addiction"},{"label":"Video: PTSD and Addiction","href":"#video-ptsd-and-addiction","heading":"Video: Post-traumatic stress disorder (PTSD) and Addiction"},{"label":"How Does PTSD Develop?","href":"#how-does-ptsd-develop","heading":"How Does Post-traumatic stress disorder (PTSD) Develop?"},{"label":"The Role of Addiction in PTSD","href":"#the-role-of-addiction-in-ptsd","heading":"The Role of Addiction in Post-traumatic stress disorder (PTSD)"},{"label":"Trauma-Informed Treatment","href":"#trauma-informed-treatment","heading":"Trauma-Informed Treatment"}],"relatedCommunity":{"community":"/community/post-traumatic-stress-disorder","basis":"topic match"},"referencePresentation":"Numbered author–date references with italic work titles, publication details, linked source names, and documented access dates. Missing publication dates use n.d.","reviewer":null,"introduction":null,"collections":[]}